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I was able to get on the state healthcare exchange site today and priced out some insurance for info purposes (still have employer healthcare so just did this for the info)

Best plan I could find is $404 per month. $500 deductible. $30 office visit Copay. Covered at 100% once Copay is paid. Prescriptions are included at 100% with no Copay (wow).

There were 38 plans to choose from these are just three of the options.

My partner Ed, likes that price of $404.00 per month, and what this offers. Although he currently has private insurance through AARP Aetna, he's going to look into this. He also received a letter a while back, stating that if he decides to go through the exchanges, he would not be permitted back into the AARP Aetna private insurance plan. ( not sure what that's about ) , but that's what the letter stated.

He currently pays about 445.00 a month for a plan that is no where as good as this one. And he knows that age (62) and location ( Florida) could very well change this pricing, but he's going to check it anyway.

He also received a letter a while back, stating that if he decides to go through the exchanges, he would not be permitted back into the AARP Aetna private insurance plan. ( not sure what that's about ) , but that's what the letter stated.

This is exactly what the letter stated, as far as not allowing Ed back into the Aetna coverage, should he decide on the exchanges.

"Please keep in mind, if you cancel your current coverage, you will not be able to purchase another AARP Essential Premier Health insurance plan. " As a result of the many health coverage options and policies available under the ACA, AARP will not be co-branding a 50-64 ( age) health insurance product in the 2014 Exchance marketplace."

=================================

So in other words,.. he's "Grandfathered into his current plan. Just wanted to clarify why he would not be allowed back into his current plan, should he decide to change.

well this morning I was able to get registered and was making my way thru the system fine, then got to the screen where to view eligibility and send info If wanted Medicaid and couldn't get past that screen to view the options.

I was able to speak to someone on the chat and she said there are still some glitches they are working every evening and to give it few more days

I came across this article this morning. A new donut hole! I know in my state they have not decide weather or not Medicaid will be expanded...

"An important issue that is highlighted from the first few days of enrollment is the number of individuals who will continue to be uninsured. Because several states have refused to expand Medicaid beginning in January 2014, millions of lower-income Americans with incomes at or below 133% of the federal poverty level, including many with HIV, will not have access to affordable health coverage. These individuals are trapped in what many are referring to as the new “donut hole”—which describes individuals who are too poor to qualify for premium subsidies, but too “wealthy” to qualify for Medicaid in their state."

this is why many have still been advocating for ADAP to remain funded.

IF every state was to fully implement the ACA, people would have access to insurance or the Medicaid Expansion program, and wouldn't need ADAP funding. In actuality, ADAP and indigent funds to hospitals is funding that is scheduled to be appropriated into the ACA. That's why the defunding notion is sorta ridiculous. Much of the ACA is already paid for by this kind of consolidation of services.

However, since quite a few states are not accepting ME, ADAP is very much needed to fill in this horrible gap. Because of the eligibility requirements, Medicaid expansion would have greatly helped many HIV positive people have easy, affordable, guaranteed access to the thing they need they most - medications. ADAP has to be renewed usually every 6 months, while ME or ACA insurance would be much more permanent.

well this morning I was able to get registered and was making my way thru the system fine, then got to the screen where to view eligibility and send info If wanted Medicaid and couldn't get past that screen to view the options.

I actually got stuck at that same spot but I get the "Downstream error" also again.

I'm done. I'm tired of spending an hour each day trying to log in. I'll wait a week or so, maybe they will find some competent people to program by then.

I really wish the administration would have done better at explaining how the law works, and how the plans work. I'm just now learning how it works, as are most.

The big complaint I see are the high deductibles. Is it correct that if you have a plan with a $5,000 deductible, then you have to pay $5,000 out-of-pocket, before your plan covers doctor visits, ER visits, meds, etc? If so, that's steep. I know that is how deductibles work, but wasn't sure whether there are benefits to reduce/help with that. Most would never spend that much for your everyday medical needs. It would only help for a major illness, so you don't end up with $50,000 to $100,000 in bills, which is great. That is really great and would help many stay out of bankruptcy.

However all the plans offered are not with a $5000 deductible. As I mentioned in my previous thread I went to my states exchange website and for a 40 year old single male non smoker there were 38 different plans to choose from with deductibles ranging from $5000 down to $500.

There didn't seem to be any difference between these new plans and what people have had historically. There's really no difference except maybe these cover more.

The big complaint I see are the high deductibles. Is it correct that if you have a plan with a $5,000 deductible, then you have to pay $5,000 out-of-pocket, before your plan covers doctor visits, ER visits, meds, etc?

I have a $2500 deductible on my employer-offered plan, but office visits, lab work, and prescriptions meds are all co-pay so they are not part of the deductible. The deductible kicks in if I'm hospitalized or have some sort of out-patient surgery. There is also "out-of-pocket" expense which is another important factor to look at.

Health insurance policies are -at least to me- unbelievably puzzling. I suppose the best thing is to call the insurer and hope that you get a representative that can answer your questions. Then call back again to see if get the same answer.

I suppose the best thing is to call the insurer and hope that you get a representative that can answer your questions. Then call back again to see if get the same answer.

or call your ASO, find out who the navigators are in your area (the federal gov't covers these navigators and their training, so there are navigators even in the red states that didn't accept Medicaid Expansion). These navigators may not be associated with your ASO, so you might have to check around.

You may even want to check on whether your ASO or some other agency has done the hard part of evaluating and rating insurance policies just for pozzies. My statewide Task Force paid for navigation training for a large group of case managers from across the state (HIV and other illnesses) and has hired a special team to evaluate all the plans on the Federal Marketplace (SC didn't want to help at all with the ACA, so we're stuck with national not local plans) to determine which of these plans might deliver better access to health care for HIV positive people in our state.

Maybe someone in your state has already produced a report or is in the process of evaluating plans and could better help an HIV+ person with getting the best policy. That's just another reason an HIV+ person should be waiting till later in this period to sign up. Give your case managers and advocates the time to do the work figuring out the list of plans that would best help you

I heard on the radio this morning that the state of Washington has signed up 25,000 -people so far for insurance under Obamacare. Now we have our own state website that actually works unlike the federal site but I think those are prettygood numbers for just fifteen days from a small/medium sized state.

I heard on the radio this morning that the state of Washington has signed up 25,000 -people so far for insurance under Obamacare. Now we have our own state website that actually works unlike the federal site but I think those are prettygood numbers for just fifteen days from a small/medium sized state.

Any updates on the federal site, is it working yet?

It would be nice to see numbers on the Fed part.

Im going to try again tonight and see if it's gotten any better. I hear the glitches are few now.

Why? To help it get better or to show how awful it's been?? Didn't you just express, in another thread, dismay at the President focusing on the bad instead of talking about how we would band together and tackle the work in front of us?

I'd rather see that they have brought in some experts to fix the website. The numbers will be bad -- we know that, but what are we doing to fix it?? We can't go back and undo the past.

It seems to me that the fed might have not had the best people in charge to develop the website. That being said, the states that CHOSE to not bother getting involved and create their own Health Exchange have themselves to blame. If you are in one of these states I would suggest you look no farther than your own Governor.

It's a massive program. It will take time.

I called today to find out who would be the best person to speak with in regard to my own situation. I was referred to a local broker. I explained my health issues and concerns and she didn't know all of the answers yet. She seemed competent and would get back to me via phone or email when she was able to get my questions answered from the state. She admitted that it takes awhile. I already know that the ACA will save us loads of money but I want to be sure to choose the right plan for us. I have time to wait for the answers.

by the way, is Affordable Care actually called Obamacare on anything official related to it? We might all work towards avoiding this term. It seems to push so many buttons in a very negative way, for people who don't like Obama, or don't like the idea of something labeled as anti-freedom, anti-American, immoral, communistic, etc.On the otherhand, if fans of Obamacare want to use the term, as a way of HONORING Obama for this great act of his Presidency and his leadership and contribution to Americans, present and future, then I guess I'm all for that.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

by the way, is Affordable Care actually called Obamacare on anything official related to it?

No, and Obama already said in a prior speech that the Repubs won't be referring to it as such when they realize that it works and people like it. "Heh heh." (oops, the heh heh sounded like Bush but for some reason it comes off better when Obama does it. Less evil and more funny)

Why? To help it get better or to show how awful it's been?? Didn't you just express, in another thread, dismay at the President focusing on the bad instead of talking about how we would band together and tackle the work in front of us?

The numbers will be bad -- we know that, but what are we doing to fix it?? We can't go back and undo the past.

M

Did I say I expected the numbers to be bad? (or did you just do that).

I think the numbers from WA are GREAT, matter of fact I saw 35k on the news. Why wouldn't I think large Fed numbers wouldnt be GREAT?

But yes, please continue to interpret my thoughts for me. You are doing a stellar job

Did I say I expected the numbers to be bad? (or did you just do that).

I think the numbers from WA are GREAT, matter of fact I saw 35k on the news. Why wouldn't I think large Fed numbers wouldnt be GREAT?

But yes, please continue to interpret my thoughts for me. You are doing a stellar job

Darling.... EVERYONE expects the Fed numbers to be bad..... No one is able to register. The website is, as you have been reporting..... Frustrating and not letting you through. Unless I missed where you succeeded

Darling.... EVERYONE expects the Fed numbers to be bad..... No one is able to register. The website is, as you have been reporting..... Frustrating and not letting you through. Unless I missed where you succeeded

M

I'm not sure what any of this has to do with "Didn't you just express, in another thread, dismay at the President focusing on the bad instead ". But Okies.

Anywho, I just talked to Sarah at Healthcare.Gov after not being able to get in again tonight, and she says I should probably create a new username and password. Will try that tomorrow.

I still can't get into the Healthcare.org website & sign up, but in the meantime I was at least finally able to get a look at the plans that are going to be available and what each one will be offering.

I already have insurance now (crazy expensive Cobra) and my anxiety level has been pretty high over the past few weeks as I try to log on each day to see what I might be eligible for on Jan 1st. I still can't sign up but at least I have a better idea now!

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Joey

"Be who you are and say what you feel, because those who mind don't matter and those who matter don't mind." - Dr. Seuss

I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.

I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.

I'm in, signed up and ready to go on Jan 1. After walking on egg shells the last twelve years without insurance, i am so grateful to have health insurance. i qualified for a bit of a subsidy which will help cover the costs.

Congratulations. I'm very happy to hear after twelve years without insurance you will no be covered. THAT is awesome!!

my friends who work in IT tell me that the problem is people who are talented just don't bid on government contracts.

It's the same people over and over who design all the government sites. It's a very specialized thing to go through the bidding process and they never pick the most expensive bid. Experienced designers can make more money in the private sector.

In the UK we have perfected the art off wasting millions on IT systems that end up scrapped millions and millions . You name it and a service will have spent money on a scrapped IT system , Fire Service, Ambulance , Police , Health , Local Gov National GOV and on and on . IN fact I am wondering if there is a public service that has not employed IT with nothing but frayed nerves at the end off it all.

Logged

"If we can find the money to kill people, we can find the money to help people ." Tony Benn

I still can't get into the Healthcare.org website & sign up, but in the meantime I was at least finally able to get a look at the plans that are going to be available and what each one will be offering.

I already have insurance now (crazy expensive Cobra) and my anxiety level has been pretty high over the past few weeks as I try to log on each day to see what I might be eligible for on Jan 1st. I still can't sign up but at least I have a better idea now!

THANK YOU for that link Noregrets. This is really what i've been trying to see. Now can they get those ValuePenquin people to DC stat to put the website together.

According to the link, I can get a Policy for $690 which is about $300 less than what I am paying now for Adult+child. It shows a 20% copay which again is less that what I pay now. But the deductable field says Info not available (weird). I think someone said all deducs are maxed out at $6k? Still no info on scrips. But hopefully when I get let into healthcare.gov ill see all the specifics

This is progress. I think ill set up a meeting with my doc and see what they think about me switching and which policy they will work best with.

Not sure if this might help but have you tried calling the number to get your questions answered?

Yes, twice. The first time I called he said I would need to go to website to "compare" policies. The second time, which was a complaint about the "downstream error", I didnt ask about quotes cause I want to be able to see them in front of me and compare them, which ValuePenquin does really good. I just couldn't see myself trying to write down quotes and all info for 6 different policies from someone I could barely understand.

I didnt click far enough in. It has all info right there for me....It says my scrips would be $100 for "preferred brand" and $150 for "non-preferred brand", so thats $300-$450/month. Of course generic is $25 but that doesnt help me with teh AIDS drugs.

LOTS of good info in there. Each policy is different of course in regards to scrips and copays, so I actually have alot of number crunching to do as there are 22 plans under Silver alone.

have you figured out a deductible? 6 thousand sounds like a lot. I didn't see any over five thousand and that was for bronze plans. I was finding 2 to 5 hundred for gold plans and one thousand for silver.

have you figured out a deductible? 6 thousand sounds like a lot. I didn't see any over five thousand and that was for bronze plans. I was finding 2 to 5 hundred for gold plans and one thousand for silver.

They are ranging from $2k to $6350 for Silver. In addition Some of the plans have prescrip deducs of $1000-$3000.

I'm actually overwhelmed by all the info, and I havent even gotten to platinum or Gold or Bronze yet

If you are HIV poz and pay for your own meds, prescription co-pays are the easiest way to sort. Look for the lowest co-pays and then compare other features.

The silver and bronze plans aren't even worth looking at. They are for people with no medical conditions.

yes, valid point

As an aside, another problem I came across is the In Network/Out of Network Physicians. One plan I was keying on as a good fit did not show my current doc as "in network", further...there were no ID docs "In Network" in San Antonio. So that plan payed zero for out of network physicians.

Deductibles, although the high figure of $6350 I apparently got from the MOOP field...

so as a correction, the deducs i'm seeing are $2k-5k

I'm certain there are lower deducs as Buggy states, I just haven't gotten to them yet.

Oh no doubt. But go into Valuepenguin and click around and see.

yes, valid point

As an aside, another problem I came across is the In Network/Out of Network Physicians. One plan I was keying on as a good fit did not show my current doc as "in network", further...there were no ID docs "In Network" in San Antonio. So that plan payed zero for out of network physicians.

I don't know what providers are offered in Texas but Blue Cross offers the most plans here in TN. I narrowed it down to three of their plans and was still confused by what they covered. After talking to some very helpful people at Blue Cross I have a better understanding. First, the deductible has to be met (including meds) on all of Blue Cross policies. Check the maximum out of pocket listed on the policy because the vary wildly. I will probably go with a higher deductible that follows with a 0% copay after the deductible is met because after paying for my meds for a month I will meet the deductible. It's gonna hurt that first month but then I won't be paying anything out of pocket after that. Call the provider if you have questions and they might be able to help.

I didnt click far enough in. It has all info right there for me....It says my scrips would be $100 for "preferred brand" and $150 for "non-preferred brand", so thats $300-$450/month. Of course generic is $25 but that doesnt help me with teh AIDS drugs.

Don't forget that most pharmaceutical companies have their own copay assistance programs. My current monthly BC-BS copay of $305 is reduced to $5 by copay assistance programs.

The copays these programs provide shouldn't be the reason you use to choose your healthcare package. They could influence whether or not you go with a package that has a bit higher out-of-pocket costs for prescriptions.

While it is an interesting article, it doesn't really have much to do with the website rollout issues. The money denied by the Republicans was for educating the public (a much needed action), but the website issues seem to stem from a complete lack of understanding on how these things work. Last minute change requests to the developers - no real end to end testing that included VOLUME of users, decisions to insists that all must create an account before even browsing, etc, etc. Anyone who has spent any time near IT development projects can tell you that these are a recipe for failure. I have not read anywhere that money was behind the website issues. This one is, I'm afraid, mainly the fault of the Administration -- piss poor project management. A little blame to all the states who refused to set up exchanges, but from what I read that wasn't the real driver behind this fiasco, just a bit of a contributing factor.

While it is an interesting article, it doesn't really have much to do with the website rollout issues. The money denied by the Republicans was for educating the public (a much needed action), but the website issues seem to stem from a complete lack of understanding on how these things work. Last minute change requests to the developers - no real end to end testing that included VOLUME of users, decisions to insists that all must create an account before even browsing, etc, etc. Anyone who has spent any time near IT development projects can tell you that these are a recipe for failure. I have not read anywhere that money was behind the website issues. This one is, I'm afraid, mainly the fault of the Administration -- piss poor project management. A little blame to all the states who refused to set up exchanges, but from what I read that wasn't the real driver behind this fiasco, just a bit of a contributing factor.

Mike

Wrong .

Quote form link . Federal legislators aren't the only ones to blame. Let's remember that original versions of the bill called for one big national exchange. This would have been much easier to implement. But conservatives declared that insurance should be left to the states and kept out of the hands of the federal government. So as a compromise (yes, those did occur), exchanges were made state-based instead of national.

As a precaution, the law stipulated that if states failed to do their duty and enact exchanges, the federal government would step in and pick up the slack. This was to prevent obstructionism from killing the law. Surprisingly, it was many of the same conservative states that demanded local control that refused to implement state-based exchanges, leaving the federal government to do it for them.

That made implementation much harder.End Quote

All of the red states that refused to set up exchanges did contribute to the website not being ready in time . All of these states except for a couple have GOP governors and it accounts for about half of the country . Its clearly caused problems .

I'm not giving a pass to the Obama administration because its a fact this roll-out could have been handled a lot better and they are ultimately the ones that are responsible .